Individual provider Active NPI

Neil Krulewitz, D.O.

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1083148837
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10960778-1204 Issued in UT
Practice address
30 N 1900 E 1C026
Department of Emergency Medicine
Salt Lake City, UT 84123
Phone
(801) 581-2730
NPI assigned
Apr 19, 2017
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 312199 NY
Emergency Medicine Physician 207P00000X 032-0133950 VT
Emergency Medicine Physician 207P00000X 10960778-1204 UT Primary

Addresses

Primary practice location

30 N 1900 E 1C026
Department of Emergency Medicine
Salt Lake City, UT 84123

Mailing address

30 N 1900 E 1C026
Department of Emergency Medicine
Salt Lake City, UT 84123

Other practice location 1

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000

Other practice location 2

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nkrulewitz244190@direct.med.utah.edu Direct University of Utah
Direct Messaging Address nkrulewitz244190@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, NY, VT3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200706003217 WY Practitioner - Emergency Medicine 0042564882 Reassigns benefits to 1 organization
I20211122002591 NY Practitioner - Emergency Medicine 0042564882 Reassigns benefits to 4 organizations
I20211201000483 VT Practitioner - Emergency Medicine 0042564882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
312199NYMDLicensed Practical Nurse
032-0133950VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabethtown Community Hospital CurrentSince Sep 2, 2021 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Champlain Valley Physicians Hospital Medical Center Emergency Medicine CurrentSince Oct 16, 2021 Accepting new patients
University of Utah Adult Services CurrentSince May 30, 2020 Accepting new patients
Elizabethtown Community Hospital Current Accepting new patients
University of Vermont Medical Center Inc Emergency Medicine CurrentSince Oct 16, 2021 Accepting new patients
Elizabethtown Community Hospital CurrentSince Sep 2, 2021 Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
  • Direct secure messaging: nkrulewitz430307@direct.uvmhealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1083148837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E 1C026",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E 1C026",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84123",
            "telephone_number": "801-581-2730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Beekman St",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129011438",
            "country_code": "US",
            "telephone_number": "518-561-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRULEWITZ",
        "first_name": "NEIL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "312199",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "032-0133950",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "10960778-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkrulewitz244190@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkrulewitz244190@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.